Trauma

Stephen Topp, T. Wylie, S. Godwin
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Abstract

DETERMINATION OF ETHYL-GLUCURONIDE AND ETHYL-SULFATE IN BLOOD BY UPLC-MS/MS: CLINICAL APPLICATION IN TRAUMA VICTIMS. We developed a UPLC-MS/MS method for the quantification of the ethanol metabolites ethyl-glucuronide (EtG) and ethyl-sulfate (EtS) in blood samples. Sample preparation was a protein precipitation with acetonitrile 0.1% formic acid containing internal standards (IS) 0.5 µg mL -1 EtG-D5 and EtS-D5. Chromatographic separation was performed in a fluoro-phenyl column, mobile phases were 0.1% formic acid in water (A) and acetonitrile (B) in gradient elution from 5% B to 70% B, with 10 min run time. Ionization was performed with electrospray source at 550 °C in negative mode, quantification mass transitions of m/z EtG 221- 75, EtS 125- 80.1, EtS-D5 130- 79.9, and EtG-D5 226- 75.1. The method was linear from 0.1 to 18 µg mL -1 for EtG and 0.02 to 6 µg mL -1 for EtS, specific, with no interfering peaks during the blank samples analyses. The method was precise and accurate, the matrix effect was compensated with the IS (-12% a + 6.1%). EtG and EtS were analyzed in 28 blood samples from trauma patients with positive alcoholaemia. The concentrations of EtG and EtS ranged from 0.25 to 14.11 µg mL -1 and 0.13 to 5.53 µg mL -1 , with high correlation with ethanol concentrations, r=0.739 and r=0.817 (p <0,001), respectively.
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超高效液相色谱-质谱联用法测定血中葡萄糖醛酸乙酯和硫酸乙酯在创伤患者中的临床应用。建立了一种UPLC-MS/MS定量测定血液中乙醇代谢物乙基葡萄糖醛酸酯(EtG)和硫酸乙基(EtS)的方法。样品制备采用含有内标(IS) 0.5µg mL -1 EtG-D5和EtS-D5的乙腈0.1%甲酸沉淀蛋白。色谱分离采用氟-苯基柱,流动相为0.1%甲酸水溶液(a)和乙腈(B),梯度洗脱范围为5% B至70% B,运行时间为10 min。用电喷雾源在550°C负模式下进行电离,量化m/z EtG 221- 75、EtS 125- 80.1、EtS- d5 130- 79.9和EtG- d5 226- 75.1的质量跃迁。该方法在0.1 ~ 18µg mL -1和0.02 ~ 6µg mL -1范围内呈线性关系,空白样品分析无干扰峰。该方法精密度高,准确度高,矩阵效应可由IS (-12% a + 6.1%)补偿。对28例酒精血症阳性创伤患者的血液样本进行EtG和EtS分析。EtG和EtS的浓度范围分别为0.25 ~ 14.11µg mL -1和0.13 ~ 5.53µg mL -1,与乙醇浓度高度相关,r=0.739和r=0.817 (p < 0.001)。
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Trauma Crisis Resource Management Comprehensive Healthcare Simulation: Emergency Medicine Standardized Participants Disaster Medicine
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